• Utilization Review Manager

    Minnesota Visiting Nurse Agency (Minneapolis, MN)
    *_SUMMARY:_* We are currently seeking a* Utilization Review Manager * to join ourTransitional Care Team.This is a full-time role and will be required to work ... ) required or completed within three years of hire **Title:** * Utilization Review Manager * **Location:** *MN-Minneapolis-Downtown Campus* **Requisition… more
    Minnesota Visiting Nurse Agency (09/30/25)
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  • Manager - Utilization Review

    Beth Israel Lahey Health (Plymouth, MA)
    …a job, you're making a difference in people's lives.** Full Time **Job Description:** ** Utilization Review & Denials management manager - Full Time** **Who ... Our Team of Experts and Serve Your Community!** **In your role as a Utilization Review & Denials Management Manager , you will:** + Directs staff performance… more
    Beth Israel Lahey Health (07/29/25)
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  • Manager , Utilization Review

    Children's Mercy Kansas City (Kansas City, MO)
    …of, and training oversight of programs and services. Responsible for effective utilization review and proper resource management of patients, including patient ... reporting, quality, and Lean process improvements, and facilitating the quarterly Utilization Review Committee meetings. Provides evidence based and outcome… more
    Children's Mercy Kansas City (09/16/25)
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  • Outcomes Manager , Utilization

    Virtua Health (Pennsauken, NJ)
    …UR Tech and AA to support UR and revenue cycle process.Position Responsibilities: Utilization Management* Utilizes Payer specific screening tools as a resource to ... resource group and payers.Documentation* Appropriate and complete documentation of clinical review and denial management in the case management documentation system… more
    Virtua Health (09/26/25)
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  • Utilization Review Coordinator

    Behavioral Center of Michigan (Warren, MI)
    …skills to help educate the staff and physicians regarding charting. REPORTS TO: Utilization Review Lead/ Manager QUALIFICATIONS: + High School Diploma or ... Under general supervision, the Utilization Review Coordinator provides professional assessment,...those duties include all tasks requested by the UR Manager , CEO or Medical Director to meet the needs… more
    Behavioral Center of Michigan (09/11/25)
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  • Utilization Review Nurse - Pool

    Dayton Children's Hospital (Dayton, OH)
    … TeamSchedule:Part timeHours:8Job Details:Under the supervision of the Manager of Utilization Management, the Utilization Review RN conducts medical ... information to payers in accordance with contractual obligations. The Utilization Review RN serves as a resource...a resource to the physicians, collaborates with the Care Manager in the development and implementation of the plan… more
    Dayton Children's Hospital (09/17/25)
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  • Care Transitions Jobs

    Beth Israel Lahey Health (Plymouth, MA)
    …Hospital-Plymouth** is expanding its **Care Transitions Department** and seeking an experienced ** Manager of Utilization Review & Denials Management** and ... + CCM, ACM, or other case management certification preferred or in progress ** Manager - Utilization Review & Denials Management** This role is ideal for a… more
    Beth Israel Lahey Health (07/03/25)
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  • Utilization Management Manager

    State of Indiana (Indianapolis, IN)
    …role of Utilization Management Manager oversees the integration of utilization review , clinically appropriate care and risk management for the purpose of ... Utilization Management Manager Date Posted: Sep 26, 2025 Requisition ID: 462259 Location: Indianapolis, IN, US, 46204 Work for Indiana Begin a fulfilling career… more
    State of Indiana (09/26/25)
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  • UM Care Manager (RN) - PA Candidates…

    UPMC (Pittsburgh, PA)
    …be given to candidates located in Pennsylvania The Utilization Management (UM) Care Manager is responsible for utilization review of health plan services ... is looking for you! We are hiring a full-time Utilization Management Care Manager to support the...information obtained from interaction with members and providers. + Review and document clinical information from health care providers… more
    UPMC (09/27/25)
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  • RN Pre Certification Case Manager

    Penn Medicine (Philadelphia, PA)
    …+ Registered Nurse - PA (Required) + 5yrs prior experience as a Nurse Case Manager with knowledge of utilization review and 3rd Party Payors (Required) ... Experience: * And 5+ years Prior experience as a nurse case manager with knowledge of utilization review and third-party payors. We believe that the best… more
    Penn Medicine (08/07/25)
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